Professor's work treating animal phobias gets attention

KALAMAZOO--Many people have a fear of a particular animal, but for some that fear can become paralyzing, threatening their career or otherwise interfering with a normal life.

Those are the people who are benefiting from new treatments being explored in a small laboratory in the northwest corner of the main floor of Western Michigan University's Wood Hall.

It's there that Dr. C. Richard Spates, professor of psychology, directs the WMU Anxiety Disorders Laboratory with help from his graduate students. And their diligent work has begun to bear fruit.

Spates' work recently was included as a chapter in a new book, the second edition of "Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies." The book, intended for use by practicing professionals, was published by Guilford Press.

In addition, a poster presentation on the same topic by WMU doctoral student Richard Seim and Spates recently won a national award at the convention of the Association for Psychological Science in Chicago.

Spates and his assistants are breaking new ground using a method known as "dosed exposure." After a series of investigations, they had reason to believe that people could be treated for an animal phobia in doses, contrary to the prevailing view that individuals had to be confronted in a prolonged and continuous way. The idea of prolonged, continuous exposure was thought to be essential and that interrupting the treatment process would weaken its effectiveness.

WMU researchers found that results using dosed exposure to the feared animal produced similar results and was easier on the person being treated.

"One of the problems with the traditionally more popular treatment approach of prolonged exposure is that a substantial number of people drop out of the therapy because it's uncomfortable for them," Spates says. "With dosed exposure, it turns out that that discomfort is not as great and the dropout rate, accordingly, is a lot less."

With fewer people dropping out of the dosed exposure treatment, more people can successfully complete it.

Here's how it works:

The treatment begins slowly, with the therapist talking about what will happen during the treatment. They let the person look at the room without the animal being present. When the therapy begins, the animal will be at the opposite end of the room in an aquarium or cage. The therapy has a graduated element, with the person asked to approach the animal in steps. The therapist measures their reactions carefully, including heart rate and other indicators, and stops the treatment when the person reaches a certain point.

"The dosed exposure procedure calls for them then to leave the room," Spates says. "They stay outside for a brief duration, a minute or so, and then come back in to approach the animal again. And when they can go as far as they can go, they go back outside, away from the animal again. That's the concept of dosing."

Under the prolonged exposure approach, the person may be able to take a short break, but always stays in the same room as the animal and starts again in a continuous fashion.

Spates says roughly 10 percent of people have an animal phobia. The most common animal phobia involves spiders, followed by snakes, rats, mice and even cats, in some cases. Treatment can produce dramatic results.

"Invariably, when people are successfully treated, they are overjoyed, hug their therapist, tears of joy in their eyes and so on," Spates says.

The dosed exposure approach grew out of experiments with the treatment of post-traumatic stress disorder. Spates actually began his research into PTSD while a graduate student at the University of Illinois. Many people in that part of the country suffer from anxiety over severe weather because of the region's violent thunderstorms and tornadoes. In some cases, their storm phobia caused problems with their employment and they would come to the lab to be treated.

Spates came to WMU some 20 years ago. He continued to investigate treatments for PTSD after the Anxiety Disorders Laboratory was established in the early 1990s.

Traditional treatment for PTSD also uses the prolonged exposure approach. The person has to confront the memory and tell the story over and over. Spates' studies achieved identical outcomes with dosed exposure, leading him and his students to repeat the procedure with other conditions, such as social anxiety and fear of public speaking and now animal phobias, as well as more exotic phobias like fear of vomiting, fear of blood and fear of injections.

"It seems to work very well in those circumstances without people dropping out of the therapy," Spates says, "and the outcomes are comparable in most ways to prolonged exposure for those individuals who stay in the therapy."

Spates plans to continue his experiments in treating PTSD. About 7 to 9 percent of people have PTSD in the general population, he says, but the rate is higher in targeted populations like military service personnel or those living in large, urban inner cities.

The high rates of PTSD among service people in Iraq and Afghanistan, estimated at 25 percent, is due, in part, to the repeated rotations in deployment. Going to Iraq, then home, then back to Iraq results in higher rates of PTSD and attendant problems, including substance abuse, suicide and co-morbid depression. The high rate of injury to soldiers from explosive devices also increases the likelihood of PTSD and its duration.

"If the estimates are right, it will entail the largest repatriation (of PTSD-affected servicemen) this country has ever experienced," Spates says. "It's something we'll be dealing with for a long time."